HCPCS Code K0903

For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each
Code effective Jan 01, 2019

HCPCS Section
Durable Medical Equipment for Medicare Administrative Contractors (DME MACs)

K0903 is a valid 2026 HCPCS code meaning For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each or (Mult den insert dir carv/cam) for short. HCPCS K0903 has been effective since 01/01/2019 and applies to Diabetic shoes.

HCPCS Code Details - K0903

HCPCS Level II Code
Section K - Durable Medical Equipment for Medicare Administrative Contractors (DME MACs)
HCPCS Code K0903
Description

Long description:
For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each

Short description:
Mult den insert dir carv/cam

HCPCS Pricing indicator 38 - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code C - Carrier judgment
BETOS2 code D1F - Prosthetic/Orthotic devices
HCPCS Action code N - No maintenance for this code
Type of service J - Diabetic shoes
Effective date Effective Jan 01, 2019
Date added Added Apr 01, 2018
Termination date Dec 31, 2018

See also

  • HCPCS K0902 · Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf

  • HCPCS A5500 · For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe

  • HCPCS A5501 · For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe

  • HCPCS A5503 · For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe

  • HCPCS A5504 · For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe

  • HCPCS A5505 · For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe

  • HCPCS A5506 · For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe

  • HCPCS A5507 · For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe

  • HCPCS A5508 · For diabetics only, deluxe feature of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe

  • HCPCS A5510 · For diabetics only, direct formed, compression molded to patient's foot without external heat source, multiple-density insert(s) prefabricated, per shoe

  • HCPCS A5512 · For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each

  • HCPCS A5513 · For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each

  • HCPCS A5514 · For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each

  • HCPCS K1001 · Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type

1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”

HCPCS Level II codes and descriptors are approved and maintained jointly by the alpha-numeric editorial panel (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association). — Updated 6/23/2026

CPT® is a registered trademark of the American Medical Association (AMA). All rights reserved.